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I was asked to join a research team to a high altitude location. As I'm really rubbish at altitude, for example feeling very exhausted during several days at around 2500m and then driving up very slowly to 3100m for just some simple sightseeing of a house is clearly too much for me. So a colleague recommended Diamox.
As I sometimes have strange side effects with medication I did a trial with just a single one - which resulted in a water weight loss of around 800gr and 5 days of extreme peeing. It literally felt like everything I put in at the top came out fairly quickly again. Of course this also messed with my electrolytes big time, and I already have low electrolytes. Neither my GP nor a pharmacist can tell me whether this is normal or whether I better not take them. I also cannot figure out who produces them in the UK to ask them. Can anyone help?
Thanks a lot.
As I sometimes have strange side effects with medication I did a trial with just a single one - which resulted in a water weight loss of around 800gr and 5 days of extreme peeing. It literally felt like everything I put in at the top came out fairly quickly again. Of course this also messed with my electrolytes big time, and I already have low electrolytes. Neither my GP nor a pharmacist can tell me whether this is normal or whether I better not take them. I also cannot figure out who produces them in the UK to ask them. Can anyone help?
Thanks a lot.
In reply to Orbitolina:
Is diamox not used to treat altitude sickness ? That’s a very different thing to being physically bad at coping with the actual physicality of being at altitude ?
PS, I am not an expert so may be talking rubbish.
Is diamox not used to treat altitude sickness ? That’s a very different thing to being physically bad at coping with the actual physicality of being at altitude ?
PS, I am not an expert so may be talking rubbish.
3
In reply to Dark-Cloud:
Yes, kind of. The way I understand it is that you adjust to altitude quicker.
Yes, kind of. The way I understand it is that you adjust to altitude quicker.
2
1
In reply to Dark-Cloud:
Don't worry! I'm more annoyed that the professionals aren't either. Though to be fair: they cannot know everything. But with seemingly no company to contact about this I'm a bit annoyed: do I hope everything goes alright or might I end up with far worse problems than high altitude?
What I forgot to mention was that I also felt some shortness of breath, but this might just be how this drug works (or loss of electrolytes?). As far as I understand it, it makes you pee out bicarbonate and potentially potassium and sodium, with are all acidity buffers: lose them from your blood and your blood pH goes down. Your body reacts by expelling CO2 to fix the pH balance and as a result you kind of breath faster and notice the altitude effect less. So.. no idea. To be honest, body chemistry is not quite the stuff I'm busy with though Similar things in other environments? Yeah!
Don't worry! I'm more annoyed that the professionals aren't either. Though to be fair: they cannot know everything. But with seemingly no company to contact about this I'm a bit annoyed: do I hope everything goes alright or might I end up with far worse problems than high altitude?
What I forgot to mention was that I also felt some shortness of breath, but this might just be how this drug works (or loss of electrolytes?). As far as I understand it, it makes you pee out bicarbonate and potentially potassium and sodium, with are all acidity buffers: lose them from your blood and your blood pH goes down. Your body reacts by expelling CO2 to fix the pH balance and as a result you kind of breath faster and notice the altitude effect less. So.. no idea. To be honest, body chemistry is not quite the stuff I'm busy with though Similar things in other environments? Yeah!
Post edited at 21:48
In reply to Orbitolina:
I am sure somebody with knowledge will chip in, but reading the way diamox works it’s all connected ctek with the kidneys etc so your initial side effects seem expected.
I am sure somebody with knowledge will chip in, but reading the way diamox works it’s all connected ctek with the kidneys etc so your initial side effects seem expected.
1
In reply to Orbitolina:
Google Acetazolamide and you'll know as much as most of us. But not how you personally react at altitude, which is really a try it and see. But it doesn't sound great for you. I used to get bad headaches at 2800m and have always been a slow acclimatiser. In the years when I worked in the Alps in the summer, I definitely improved. So perhaps I'm a slow acclimatiser rather than a bad one. So might you be. But if you have kidney issues, you might not want to test it out.
Google Acetazolamide and you'll know as much as most of us. But not how you personally react at altitude, which is really a try it and see. But it doesn't sound great for you. I used to get bad headaches at 2800m and have always been a slow acclimatiser. In the years when I worked in the Alps in the summer, I definitely improved. So perhaps I'm a slow acclimatiser rather than a bad one. So might you be. But if you have kidney issues, you might not want to test it out.
In reply to Orbitolina:
Have you tried contacting the BMC or the BMC's medical advisor Dr David Hillebrandt?
https://www.thebmc.co.uk/how-to-get-mountain-medicine-advice
Have you tried contacting the BMC or the BMC's medical advisor Dr David Hillebrandt?
https://www.thebmc.co.uk/how-to-get-mountain-medicine-advice
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In reply to Orbitolina:
I have never taken Diamox, but that makes a lot of sense from my experience of altitude-related headaches. When I was in Kenya I spent over a week above 4000 metres, and along with all the members of my party I experienced altitude-related headaches. I still remember that the headache would always disappear when I had a pee. I assumed at the time that a reduction in blood pressure was responsible for the headache disappearing.
I have never taken Diamox, but that makes a lot of sense from my experience of altitude-related headaches. When I was in Kenya I spent over a week above 4000 metres, and along with all the members of my party I experienced altitude-related headaches. I still remember that the headache would always disappear when I had a pee. I assumed at the time that a reduction in blood pressure was responsible for the headache disappearing.
In reply to Dark-Cloud:
Yep, sounds normal. But Diamox seems to have a half-life of less than half a day. I'd not expect to experience these effects for 5 days. But what do I know?!?
Yep, sounds normal. But Diamox seems to have a half-life of less than half a day. I'd not expect to experience these effects for 5 days. But what do I know?!?
In reply to Andy Nisbet:
I don't have much experience with high altitude to be honest. Yes, headaches happen when I go too high, but I'm also extremely weak and exhausted before I even get to the altitude where I get those headaches. And after two weeks between 1000-2000m (crossing Iran) I was still not able to run at 1000m.
My gut feeling tells me it's not a good idea, but it's such an amazing chance *sigh*
I don't have much experience with high altitude to be honest. Yes, headaches happen when I go too high, but I'm also extremely weak and exhausted before I even get to the altitude where I get those headaches. And after two weeks between 1000-2000m (crossing Iran) I was still not able to run at 1000m.
My gut feeling tells me it's not a good idea, but it's such an amazing chance *sigh*
In reply to Orbitolina:
Rather than your GP, it would be better to get a consultation (privately, this won't be NHS) with someone who is experienced in altitude medicine. This is fairly specialised stuff. Is this organised research - i.e. would the team pay for a consultation?
Rather than your GP, it would be better to get a consultation (privately, this won't be NHS) with someone who is experienced in altitude medicine. This is fairly specialised stuff. Is this organised research - i.e. would the team pay for a consultation?
In reply to Orbitolina:
And after two weeks between 1000-2000m (crossing Iran) I was still not able to run at 1000m.
wow, that really is bad, I would barely consider 1000m being at altitude? though I wonder how much of that was altitude and how much was diet or some other travel related issue...?
I would expect taking Diamox at low level as a 'test' to have rather different results to actually using it at altitude, as it wont be 'treating' the ailment it is meant for? so this might not be representative as to how you will actually feel when up high?
some people do take Diamox prophylactically when travelling to only moderate altitudes, but it is no substitute for actually acclimatising properly. if your going on an organised expedition then there must be somebody you can talk to, if not an expedition medic then at least somebody in charge?
And after two weeks between 1000-2000m (crossing Iran) I was still not able to run at 1000m.
wow, that really is bad, I would barely consider 1000m being at altitude? though I wonder how much of that was altitude and how much was diet or some other travel related issue...?
I would expect taking Diamox at low level as a 'test' to have rather different results to actually using it at altitude, as it wont be 'treating' the ailment it is meant for? so this might not be representative as to how you will actually feel when up high?
some people do take Diamox prophylactically when travelling to only moderate altitudes, but it is no substitute for actually acclimatising properly. if your going on an organised expedition then there must be somebody you can talk to, if not an expedition medic then at least somebody in charge?
In reply to Orbitolina:
Initially I suggest contacting the BMC via their website ( www.thebmc.co.uk). You could perhaps ask for your enquiry to be passed on to David Hillebrandt.
You could also try contacting the British Mountain Medicine Society via their website (thebmms.org).
I would be surprised if these initial enquiries cost anything - it costs nothing to ask.
Initially I suggest contacting the BMC via their website ( www.thebmc.co.uk). You could perhaps ask for your enquiry to be passed on to David Hillebrandt.
You could also try contacting the British Mountain Medicine Society via their website (thebmms.org).
I would be surprised if these initial enquiries cost anything - it costs nothing to ask.
1
In reply to Orbitolina:
The percentage oxygen at 1000m is the same as at sea-level (despite air pressure being less), so not being able to run must be due to something else. It's not till about 1500m it becomes less. Altitude training for athletes is often done around 2000m.
The percentage oxygen at 1000m is the same as at sea-level (despite air pressure being less), so not being able to run must be due to something else. It's not till about 1500m it becomes less. Altitude training for athletes is often done around 2000m.
In reply to Orbitolina:
Some bed time reading here http://theuiaa.org/mountain-medicine/medical-advice/
and here
http://medex.org.uk/medex_book/english_version.php
Some bed time reading here http://theuiaa.org/mountain-medicine/medical-advice/
and here
http://medex.org.uk/medex_book/english_version.php
1
In reply to Andy Nisbet:
Percentage oxygen remains the same at just over 20% to the summit of Everest and beyond. It is just the reduction in air pressure that means you get less oxygen with each breath
> The percentage oxygen at 1000m is the same as at sea-level (despite air pressure being less), so not being able to run must be due to something else. It's not till about 1500m it becomes less. Altitude training for athletes is often done around 2000m.
Percentage oxygen remains the same at just over 20% to the summit of Everest and beyond. It is just the reduction in air pressure that means you get less oxygen with each breath
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In reply to Denzil:
It must have changed since I read that 30 years ago!
> Percentage oxygen remains the same at just over 20% to the summit of Everest and beyond. It is just the reduction in air pressure that means you get less oxygen with each breath
It must have changed since I read that 30 years ago!
In reply to Orbitolina:
The reduction in inspired oxygen patial pressure is very little at 1000m, and usually considered insignificant.
If you can't run without excessive breathlessnesss (very subjective) you should discuss this with your doctor without focussing on the altitude (ie if you approach a general dr and tell him that you tolerate altitude poorly then they might focus on that rather than considering other more general problems) - attributing this soley to poor tolerance of altitude without some exploration of other cardiorespiratory issues might not give you the whole answer.
The reduction in inspired oxygen patial pressure is very little at 1000m, and usually considered insignificant.
If you can't run without excessive breathlessnesss (very subjective) you should discuss this with your doctor without focussing on the altitude (ie if you approach a general dr and tell him that you tolerate altitude poorly then they might focus on that rather than considering other more general problems) - attributing this soley to poor tolerance of altitude without some exploration of other cardiorespiratory issues might not give you the whole answer.
In reply to Andy Nisbet:
The reduction in partial pressure of oxygen in air compared to sea level will reduce by approximately 10% at 900m, 20% at 1800m, 29% at 2700m, 44% at 4500m, 54% at 6100m, 63% at 7600m and 70% at 9100m. The reduction in human physiological performance with altitude will be linked to this but also depend on individual factors including acclimatization. Speeds achieved in some sports events at altitude can be greater than those achieved at sea level because the lower atmospheric pressure gives less wind resistance.
The reduction in partial pressure of oxygen in air compared to sea level will reduce by approximately 10% at 900m, 20% at 1800m, 29% at 2700m, 44% at 4500m, 54% at 6100m, 63% at 7600m and 70% at 9100m. The reduction in human physiological performance with altitude will be linked to this but also depend on individual factors including acclimatization. Speeds achieved in some sports events at altitude can be greater than those achieved at sea level because the lower atmospheric pressure gives less wind resistance.
In reply to Orbitolina:
Sorry to hi-jack the post. I cannot claim to know too much about altitude but 2500-3000m does not seem particularly high to be thinking about using Diamox. I know altitude affects everyone differently but I've found that I don't really notice any worrying problems at that sort of altitude; certainly no headaches, nausea etc. In Nepal I didn't really even think about using it until above 4000m. As I said, I know it's an individual sort of thing - perhaps I've been lucky.
Sorry to hi-jack the post. I cannot claim to know too much about altitude but 2500-3000m does not seem particularly high to be thinking about using Diamox. I know altitude affects everyone differently but I've found that I don't really notice any worrying problems at that sort of altitude; certainly no headaches, nausea etc. In Nepal I didn't really even think about using it until above 4000m. As I said, I know it's an individual sort of thing - perhaps I've been lucky.
In reply to mypyrex:
You are lucky (though no luckier than plenty of others). Trekkers have died of AMS lower than 4000m in Nepal. The most ill I've ever been with altitude was at 4000m in Nepal having taken three days walking up a valley to get there.
> In Nepal I didn't really even think about using it until above 4000m. As I said, I know it's an individual sort of thing - perhaps I've been lucky.
You are lucky (though no luckier than plenty of others). Trekkers have died of AMS lower than 4000m in Nepal. The most ill I've ever been with altitude was at 4000m in Nepal having taken three days walking up a valley to get there.
In reply to Orbitolina:
The usual advice for anyone who experiences side effects to a drug is to discuss the effects with the doctor who prescribed the drug. You do not say if you have done this.
Diamox is unlicensed for the prevention of altitude sickness in the UK and for this reason many doctors will not prescribe it, saying, correctly, that they do not have the expertise required to do so safely. That said, many online pharmacies will dispense Diamox following an on line consultation with their "tame" doctor.
The usual advice for anyone who experiences side effects to a drug is to discuss the effects with the doctor who prescribed the drug. You do not say if you have done this.
Diamox is unlicensed for the prevention of altitude sickness in the UK and for this reason many doctors will not prescribe it, saying, correctly, that they do not have the expertise required to do so safely. That said, many online pharmacies will dispense Diamox following an on line consultation with their "tame" doctor.
In reply to Orbitolina:
Hi,
Just so you know, airplane cabins are traditionally pressurised to be the equivalent of over 2000m altitude (I think the legal limit is 2400m, as this is regarded as the lowest limit where altitude starts to affect stationary people - I'm going off memory here though).
If you're that sensitive to altitude, it's worth bearing in mind.
Hi,
Just so you know, airplane cabins are traditionally pressurised to be the equivalent of over 2000m altitude (I think the legal limit is 2400m, as this is regarded as the lowest limit where altitude starts to affect stationary people - I'm going off memory here though).
If you're that sensitive to altitude, it's worth bearing in mind.
In reply to Orbitolina:
Peeing a lot has little effect on your electrolyte balance. Though drinking a lot in response likely will affect it.
Orbitolina wrote:
Key missing concept here is that at the altitudes you're considering, low Carbon Dioxide is usually a more important for altitude sickness symptoms than low Oxygen. Low CO2 causes alkalosis. Having the wrong pH screws up lots of biochemical reactions, so it's likely a cause of many AMS symptoms. Acetazolamide helps return the pH of your blood to normal range -- which in itself resolves many of the symptoms.
Breathing more frequently does not solve most altitude problems, otherwise people would just do that (without any need to take Diamox). If anything, breathing faster and deeper makes the low CO2 alkalosis problem worse -- by increasing the exposure and thus the rate of depletion of CO2 from the blood.
I've been taking acetazolamide on every trip I make to 3000 meters, for decades now. Every time I pee more for the first two or three days (one reason it's useful to follow the _instructions_ and start taking it at least two days _before_ going to altitude).
My results make it way worth it to keep on taking it (and enduring the peeing) every time. (like right now I'm starting a trip today).
Ken
> Don't worry! I'm more annoyed that the professionals aren't either.
huh? Just read the label: peeing is the expected effect. Whatever else it might do in the body, Acetazolamide is surely a diuretic.Peeing a lot has little effect on your electrolyte balance. Though drinking a lot in response likely will affect it.
Orbitolina wrote:
> Your body reacts by expelling CO2 to fix the pH balance and as a result you kind of breath faster
> and notice the altitude effect less. So.. no idea.
> and notice the altitude effect less. So.. no idea.
Key missing concept here is that at the altitudes you're considering, low Carbon Dioxide is usually a more important for altitude sickness symptoms than low Oxygen. Low CO2 causes alkalosis. Having the wrong pH screws up lots of biochemical reactions, so it's likely a cause of many AMS symptoms. Acetazolamide helps return the pH of your blood to normal range -- which in itself resolves many of the symptoms.
Breathing more frequently does not solve most altitude problems, otherwise people would just do that (without any need to take Diamox). If anything, breathing faster and deeper makes the low CO2 alkalosis problem worse -- by increasing the exposure and thus the rate of depletion of CO2 from the blood.
I've been taking acetazolamide on every trip I make to 3000 meters, for decades now. Every time I pee more for the first two or three days (one reason it's useful to follow the _instructions_ and start taking it at least two days _before_ going to altitude).
My results make it way worth it to keep on taking it (and enduring the peeing) every time. (like right now I'm starting a trip today).
Ken
1
In reply to Orbitolina:
Can you go for a visit to see? You may get a better idea then. I've always been strong at altitude, but take the piss with acclimatisation, usually going over what is recommended. If you could take time for slow acclimatisation first it may be okay. You just can never tell.
Can you go for a visit to see? You may get a better idea then. I've always been strong at altitude, but take the piss with acclimatisation, usually going over what is recommended. If you could take time for slow acclimatisation first it may be okay. You just can never tell.
In reply to kenr:
I'll say it is! Nearly a litre one night.
> huh? Just read the label: peeing is the expected effect. Whatever else it might do in the body, Acetazolamide is surely a diuretic.
I'll say it is! Nearly a litre one night.
1
In reply to iani:
Cheers. I believe figures.
> The reduction in partial pressure of oxygen in air compared to sea level will reduce by approximately 10% at 900m, 20% at 1800m, 29% at 2700m, 44% at 4500m, 54% at 6100m, 63% at 7600m and 70% at 9100m. The reduction in human physiological performance with altitude will be linked to this but also depend on individual factors including acclimatization. Speeds achieved in some sports events at altitude can be greater than those achieved at sea level because the lower atmospheric pressure gives less wind resistance.
Cheers. I believe figures.
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